Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 2007-01581 | NC |
NPI | 1184752131 |
---|---|
Provider Name | Dr. Michael Dean Hightower |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 26/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4095791 | BCBS OF TN (01) | TN |
5909076 | (05) | NC |
A440 | (05) | TN |
C70128 | (02) | TN |